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송정수 ( Jeong Soo Song ),박원 ( Won Park ),엄희섭 ( Hee Sup Um ),배성권 ( Sung Kwon Bae ),최승원 ( Seung Won Choi ),김명구 ( Myung Ku Kim ),이종욱 ( Jong Wook Lee ),배수환 ( Soo Hwan Bae ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Systemic lupus erythematosus(SLE) is a prototypic autoimmune disease characterized by the production of antibodies to components of the cell nucleus in association with a diverse array of clinical manifestations. Infection is a major source of morbidity and mortality in patients with SLE. Although the most frequent etiologic agents are pyogenic organisms such as Staphylococcus species and Escherichia coli, opportunistic pathogens such as uncommon bacteria, fungal organisms, viruses and protozoans have been described. Cases of osteomyelitis due to Salmonella have been reported worldwide, however, it has never been reported in the Korean literature. A 35-year-old female patient with SLE, who was treated with corticosteroid was complicated by osteomyelitis on the left distal femur. A computerized tomography guided aspiration showed greenish yellow pus. Salmonella enteritidis was cultured from the pus. Incision and pus drainage was performed. After 6 weeks of antibiotic therapy, fever, local heat, and swelling improved and she was discharged. We report this patient with a review of relevant literatures.
김성수 ( Sung Soo Kim ),박원 ( Won Park ),배성권 ( Sung Kwon Bae ),송정수 ( Jeong Soo Song ),문경호 ( Kyung Ho Moon ),이정윤 ( Joung Yoon Lee ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2
Septic arthritis is a disease that causes a rapid joint destruction by various kinds of bacteria such as Staphylococcus aureus. It affects more frequently the patients with rheumatoid arthritis, diabetes, immunocompromised patients, and chronic steroid users. In patients with rheumatoid arthritis, 1 to 12% of patients are affected by septic arthritis. In these patients, it is very difficult to distinguish between an acute exacerbation of rheumatoid arthritis and a development of septic arthritis if the latter affects more than one joint. Septic arthritis usually affects single joint, especially the knee joint. If the diagnosis and treatment are delayed, it would cause sepsis resulting in high mortality and morbidity. Thus early diagnosis by arthrocentesis, prompt drainage, and antibiotics therapy are essential. We experienced a 46 years-old woman with rheumatoid arthritis who abused the steroids for 10 years and complaining recent aggravation of bilateral knee joint swelling, warmth, and tenderness. Large amount of pus from both knees showed Gram positive cocci. The immediate open surgical drainage of both knees was done. The patient recovered from septic arthritis after 6 weeks of antibiotics therapy. The synovial fluid microbiology study should be done in all joints of the patients with the risk factors of joint infection.
횡단성 척수염이 첫증상으로 발현된 전신성 홍반성 루푸스
조병관 ( Byung Kwan Cho ),송정수 ( Jeong Soo Song ),배성권 ( Sung Kwon Bae ),윤승재 ( Seung Jae Yoon ),박원 ( Won Park ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.3
This is a case report of systemic lupus erythematosus presented as a transverse myelitis. Central nervous system involvement in systemic lupus erythematosus is a relatively common complication. But the transverse myelitis as a central nervous system involvement in systemic lupus erythematosus is rare and the transverse myelitis as the first manifestation of systemic lupus erythematosus has not been reported in Korea. Thus we report a case of the transverse myelitis as a first manifestation of systemic lupus erythematosus with the literature review.
박원(Won Park),송정수(Jeong Soo Song) 대한내과학회 1999 대한내과학회지 Vol.56 No.6
N/A Objective : This study was aimed to evaluate the prevalence, titer and patterns of antinuclear antibody (ANA) expression, and its clinical significance in patients with rheumatoid arthritis (RA). Methods : We divided 259 patients with seropositive RA into ANA positive and negative groups and compared the two groups with multiple clinical variables. Results : 47.5% of patients with seropositive RA expressed ANA. Most of the patterns of ANA were homogenous (52.8%) and speckled (36.6%). Most frequently expressed anti-extractable nuclear antigen (ENA) antibody was anti-Ro antibody (34.1%). Patients in the ANA positive group had higher frequency of anemia, lower hemoglobin concentration, more hot joint area on radionuclide whole body bone scan, and lower T-score on bone mineral density (BMD) than patients in the ANA negative group. But other clinical parameters which reflect disease activity and systemic involvement were not different significantly between the two groups. Most patients expressed lower ANA (63.1%). Patients with high ANA titer were older and had lower hemoglobin concentration than patients with lower ANA titer. Conclusions : Almost the half of seropositive RA patients expressed ANA. Most of them had homogenous and speckled ANA pattern. Anti-Ro antibody was most frequent anti-ENA antibody. Except anemia, hot joint area in whole body bone scan, and BMD, the expression of ANA in patients with RA can not reflect disease activity and systemic involvement accurately.
임희정 ( Hee Jung Lim ),박원 ( Won Park ),박보형 ( Bo Hyoung Park ),김현정 ( Hyun Jeong Kim ),김성수 ( Sung Soo Kim ),이용환 ( Yong Hwan Lee ),송정수 ( Jung Soo Song ),진희승 ( Hee Seung Jin ),최원식 ( Won Sick Choe ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.1
Wegener`s granulomatosis (WG) is a syndrome characterized by necrotizing granulomatosis lesions in the upper and lower respiratory tracts, glomerulonephritis, and generalized vasculitis involving both arteries and veins. This syndrome usually affects the upper and lower respiratory tract and the kidneys. Some patients with WG have cardiac involvement such as pericarditis, myocarditis, valvulitis, arrhthymia, coronary arteritis, and rarely cardiomyopathy. Ocular manifestations include keratitis, conjuntivitis, scleritis, retro-orbital granuloma with proptosis. Uncommonly, blindness may occur due to retinal vasculitis and optic neuritis. We report a 45-year-old female patient with WG who had sinusitis and lung nodules. She complained of sudden chest pain. Electocardiography and nuclear myocardial perfusion study suggested transient myocardial ischemia. During the active course of the disease, she complained of severe pain in the right eye-ball with decreased visual acuity. Subsequently, she developed monocular blindness probably due to retinal vasculitis.
송정수,박원 대한내과학회 1998 대한내과학회지 Vol.55 No.3
Protein S is a natural anticoagulant present in the plasma that serves as a cofactor for activated protein C. The protein S level is decreased in congenital deficiency, inflammatory syndrome, DIC, hepatic disorders, malignancy, and oral anticoagulant (warfarin) therapy. Protein S deficiency provokes recurrent thromboembolism, superficial and/or deep vein thrombosis. Behcet`s disease is a multisystemic disorder presenting with recurrent oral and genital ulcerations as well as ocular involvement. The mechanism of vascular involvement of Rehcet`s disease is not fully understood. This is a case report of Behcet`s disease associated with protein S deficiency in a 44 year old male patient with deep vein thrombosis. We report the case with relevant literature review.
단백상실성 장병증 후에 발병된 Reflex Sympathetic Dystrophy Syndrome 1예
김영수,최원,장재남,송정수,신용운,권계숙,이돈행,김범수,박원,김형길,현인영,이경주,조현근 대한내과학회 1999 대한내과학회지 Vol.56 No.1
A 16-year old girl was admitted for chronic diarrhea, generalized edema, severe pain of lower extremities, and general weakness. She could not walk because of burning pain of knee and ankle. 99mTc-MDP bone scan demonstrated increased periarticular uptake in both lower extremity with focal increased activity in proximal portion of both tibias.. Abnormal abdominal activity in ascending, transverse, and descending colon is also seen. Bone densitometry showed severe osteoporosis in lower extremity. 99mTc-HSA scan showed abnormal radioactivity in small bowel, and descending colon indicating protein losing enteropathy. Endoscopic biopsy of terminal ileum showed a few dilated lymphatics in the submucosa. After steroid and supplemental therapy, the symptoms and signs of both protein losing enteropathy and RSDS much improved simultaneously. Reflex sympathetic dystrophy syndrome is a complex of symptoms characterized by severe pain, swelling, autonomic vasomotor dysfunction, and impaired mobility of affected extremities. The important causes are trauma, fracture, and inflammation. We assumed that the reflex sympathetic dystrophy syndrome of this girl was due to protein losing enteropathy. And as far as we know there has not been reported case that protein losing enteropathy assumed as a cause of reflex sympathetic dystrophy syndrome.